[0001] The present invention relates to concentrated suspensions of water insoluble pharmaceutical
substances, to their preparation process and their use to prepare therapeutically
acceptable suspensions ready for inhalatory administration.
[0002] An effective inhalation therapy requires that particles of any drugs are delivered
to the lower airways surfaces, particularly in the deep lung region, which is the
site of drug action where the main pharmacological effects occur. To achieve delivery
in the deep lung region, the size of the drug particles must be such as to avoid early
deposition in the upper airways. As it is well known, the respiratory tract acts as
a filter of the inhaled particles, which are captured and deposited depending on their
size. Drug particles which ensure optimal deposition have a size in the range between
0.1 and 10 µm, preferably between 0.5 and 7 µm.
[0003] Although widely used, suspensions of pharmaceutical substances may be difficult to
prepare, particularly with respect to their physical stability. A drawback of such
suspensions is the tendency of the particles to agglomerate and form a precipitate
that settles at rest over time. Suitable surfactants and salts usually assist in re-dispersing
the settled particles by gentle shaking, so that a homogeneous suspension is re-established.
When such sediment of settled particles is not easily broken or the particles cannot
be easily re-dispersed since have undergone coagulation, a risk exists that a wrong
dose of substance is administered to a patient, either in excess or in defect.
[0004] A drug to be administered as an inhalatory suspension must be micronized to cut down
the size to less than 10 µm. Such size reduction, typically performed in a dry state,
may lead to an initial aggregation of drug particles. Thus, the corresponding suspension
for inhalatory administration is prepared by suspending the drug in water by means
of a high energy mixer, or often by a turboemulsifier.
[0005] WO 00/25746 discloses a process for the preparation of inhalatory suspensions by
dispersing micronized drug particles in water in a turboemulsifier provided with magnetic
stirring, optionally followed by treatment in a high-pressure homogenizer. The operating
conditions adopted require the turboemulsifier to be operated at a speed comprised
between 2500 and 2600 rpm, for a time of 15-20 minutes. The size of the particles
of a suspension produced by this method, however, does not appear to be improved over
the conventional inhalatory suspensions, the size distribution being as follows: d(0.1)
= 0.76 µm; d(0.5) = 3.01 µm; d(0.9) = 9.42 µm, with a calculated span value of [d(0.9)
- d(0.1)]/d(0.5) = 2.88. Implementation of a subsequent dispersion step in a high-pressure
homogenizer at a pressure as high as 1000 bar generated an inhalatory suspension with
the following size distribution: d(0.1) = 0.82 µm; d(0.5) = 2.43 µm; d(0.9) = 5.07
µm, with a calculated span value of [d(0.9) - d(0.1)]/d(0.5) = 1.75.
[0006] These results show that the process described in WO 00/25746 brings about a slight
reduction of about 0.6 µm in d(0.5), a more meaningful reduction of about 4 µm in
d(0.9) and an improvement of the span only when a dispersion step in a high pressure
homogenizer is implemented after a dispersion step in a turboemulsifier. It appears
that such a high pressure treatment is required to achieve a size reduction of the
coarser fraction as indicated by the d(0.9) values, thereby making the process burdensome
and economically less attractive.
[0007] With respect to sterilization of aqueous suspensions of pharmaceutical substances,
particularly of glucocorticosteroids, it is reported in WO 99/25359 that attempts
at terminal sterilization of such suspensions have all proved unsatisfactory.
[0008] It would therefore be desirable to provide a process to prepare suspensions of pharmaceutical
substances for inhalatory administration which is efficient, economically attractive
and capable of producing stable suspensions over the time, so that a desired drug
dose can be administered to a patient.
[0009] It would also be desirable to provide a process to effectively sterilize drug particles
in suspension with satisfactory results.
[0010] Further, it would be desirable to provide inhalatory suspensions of drug particles
that can be prepared extemporaneously, namely just before administration.
[0011] According to a first aspect of the invention, it is provided a concentrated suspension
of water insoluble pharmaceutical substances, characterized by comprising:
a) micronized particles of at least one water insoluble pharmaceutical substance with
a particle size distribution in which the d(0.5) fraction is less than 3 µm, the span
value is less than 2, and such features are retained upon aging the suspension for
90 days; said pharmaceutical substance being present at a concentration between 5
to 50 times the concentration of a suspension for inhalatory administration;
b) an aqueous solution of a pharmaceutically acceptable surfactant as dispersing medium
for said micronized particles of pharmaceutical substance;
c) a salt dissolved in said aqueous solution, at a concentration that: i) does not
cause coagulation of said particles of pharmaceutical substance ; and ii) generates
upon dilution an inhalatory suspension in which the concentration of salt in the aqueous
phase is not higher than 10 g/l.
[0012] According to a second aspect, the invention provides a process to prepare a concentrated
suspension of water insoluble pharmaceutical substances, characterized by comprising
the following steps:
a) dissolving at least one pharmaceutically acceptable surfactant in water to form
an aqueous solution of said surfactant;
b) suspending in said aqueous solution micronized particles of said water insoluble
pharmaceutical substance with a particle size distribution in which the d(0.5) fraction
is less than 3 µm and the span value is less than 2, at a concentration between 5
and 50 times the concentration of said pharmaceutical substance in a therapeutically
acceptable suspension for inhalatory administration;
c) dissolving a salt in said aqueous solution, at a concentration that: i) does not
cause coagulation of said particles of pharmaceutical substance; and ii) generates
upon dilution an inhalatory suspension in which the concentration of salt in the aqueous
phase is not higher than 10 g/l,
said steps being carried out under stirring and at a pressure not higher than 2 bar.
[0013] According to a third aspect, the invention provides a sterilization process of a
concentrated suspension of water insoluble pharmaceutical substances, characterized
by subjecting said concentrated suspension to
β or
γ irradiation.
[0014] A fourth aspect of the invention provides a
β or
γ irradiated concentrated suspension of water insoluble pharmaceutical substances,
characterized by comprising:
a) micronized particles of at least one water insoluble pharmaceutical substance having:
i) a particle size distribution in which the d(0.5) fraction is less than 4 µm, the
d(0.9) fraction is less than 9 µm, the span value is less than 2.5 upon aging the
suspension for 90 days;
ii) a reduction in total purity of the active material of less than 0.5% from the
initial purity of the untreated material;
said pharmaceutical substance being present at a concentration of between 0.5 and
100 g/l;
b) an aqueous solution of a pharmaceutically acceptable surfactant as dispersing medium
for said micronized particles of pharmaceutical substance;
c) a salt dissolved in said aqueous solution, at a concentration that: i) does not
cause coagulation of said particles of pharmaceutical substance; and ii) generates
upon dilution an inhalatory suspension in which the concentration of salt in the aqueous
phase is not higher than 10 g/l.
[0015] A fifth aspect of the invention provides an irradiation treated inhalatory suspension
of at least one water insoluble pharmaceutical substances, characterized by comprising:
a) micronized particles of at least one water insoluble pharmaceutical substance with
a particle size distribution in which the d(0.5) fraction is less than 3 µm, the d(0.9)
fraction is less than 7 µm, the span value is less than 2, said pharmaceutical substance
being present at a concentration between 0.1 and 2.0 g/l;
b) an aqueous solution of a pharmaceutically acceptable surfactant as dispersing medium
for said micronized particles of pharmaceutical substance and of a salt in which the
concentration of said salt is not higher than 10 g/l.
[0016] A sixth aspect of the invention provides a kit for the extemporaneous preparation
of a suspension of water insoluble pharmaceutical substances intended for inhalatory
administration, characterized by comprising a concentrated suspension of said water
insoluble pharmaceutical substances and a separate diluent in proportions such that
upon mixing said diluent with said concentrated suspension, a suspension ready for
inhalatory administration is obtained.
[0017] With the expression "pharmaceutical substance" it is a meant a substance exerting
a biological activity, typically for therapy, prophylaxis or diagnosis purposes.
[0018] With the expression "substance insoluble in water" it is meant a substance having
a solubility in water of less than 10 g/l, usually of less than 5 g/l, and even of
less than 1 g/l.
[0019] Pharmaceutical substances suitable to be administered as inhalatory suspensions are
β2-receptors active substances, glucocorticoids, other antiallergic or anti-inflammatory
substances or derivatives thereof, although the invention is not limited to them.
[0020] Suitable
β2-receptors active substances are terbutaline, salbutamol, mabuterol, fenoterol, formoterol,
orciprenaline, isoprenaline, isoetharine, clenbuterol, hexoprenaline, procaterol,
1-(4-hydroxyphenyl)-2-[1,1-dimethyl-3-(2― methoxyphenyl) propylamino]-ethanol, 1-(3,5-dihydroxyphenyl)-2-[1,
1-dimethyl-3-(2-methoxyphenyl) propylamino] -ethanol, 1-3, 4-dihydroxyphenyl )-2-[1,
1-dimethyl-3-(2-methoxyphenyl) propylamino] -ethanol, (4-hydroxy-α'-[[[6-(4-phenylbutoxy)
-hexyl] -amino] -methyl]-1,3 benzyldimetha-nol, pharmacologically acceptable salts
or derivatives thereof and compounds of similar pharmacological properties.
[0021] Suitable glucocorticoids are compounds like budesonide, beclomethasone, dexamethasone,
flumethasone, flunisolide, fluticasone, triamcinolone acetonide, 17- and/or 21-esters
of these steroids, pharmacologically acceptable salts thereof and compounds of similar
pharmacological properties.
[0022] Preferred pharmaceutical substances according to the invention are budesonide, beclomethasone
dipropionate (BDP), mometasone furoate, fluticasone propionate their derivatives and
similar glucocorticoids with anti-inflammatory activity.
[0023] A suspension ready for inhalatory administration, or inhalatory suspension, as intended
in the present application, is a suspension of one or more pharmaceutical substance
insoluble in water at a concentration not higher than 2 g/l. Preferably, the concentration
of the pharmaceutical substance in an inhalatory suspension is between 0.1 and 1.5
g/l.
[0024] Typical inhalatory suspensions of BDP have a concentration of 0.4 g/l; typical inhalatory
suspensions of budesonide have a concentration of 0.25 or 0.5 g/l; typical inhalatory
suspensions of fluticasone have a concentration of 0.25 or 1.00 g/l.
[0025] As mentioned above, physical stability over the time is a critical aspect of suspensions
pharmaceutical substances. Burdensome production process is another critical aspect.
[0026] In a first aspect, the invention provides a concentrated non-inhalatory suspension
of water insoluble pharmaceutical substances that is relatively simple to produce,
is stable over the time, allows easy storage, transportation and handling, in particular
effective sterilization, and can be used to prepare inhalatory suspensions with the
required particle size distribution by simple dilution, either at a production site
or directly before administration (extemporaneous preparation).
[0027] By "micronization" in the present context is meant a process involving mechanical
means, for instance milling or grinding, to reduce the particle size to the micrometer
range. Information about micronization can be found e.g. in "The Theory and Practice
of Industrial Pharmacy", Lachman, Liebermann and Klang, 2
nd Ed., Lea & Febiger, Philadelphia, USA.
[0028] Upon aging of 90 days, the micronized particles of the water insoluble pharmaceutical
substance in the concentrated non inhalatory suspension of the invention are characterized
by a particle size distribution in which the d(0.5) fraction is less than 3, the d(0.9)
fraction is less than 9 µm and the span value is less than 2. Preferably, the d(0.9)
fraction is less than 7 µm. Such distribution ensures good stability during storage
and is designed to generate by simple dilution an inhalatory suspension with optimal
drug delivery in the lower airways surfaces.
[0029] Furthermore, the concentration of water insoluble pharmaceutical substance in the
concentrated non inhalatory suspension varies from 5 to 50 times the concentration
of such substance in a suspension for inhalatory administration. Since this latter
concentration is not higher than 2 g/l, the maximum concentration of the pharmaceutical
substance in the concentrated non inhalatory suspension is 100 times this value, namely
200 g/l. Preferably, the concentration of the pharmaceutical substance in the concentrated
non inhalatory suspension is comprised between 0.2 : 150 g/l, the preferred concentration
range of the same substance in the inhalatory suspension being 0.1:1.5 g/l. More preferably
the concentration of the pharmaceutical substance in the concentrated non inhalatory
suspension is comprised between 0.5 : 10 g/l, even more preferably between 1 and 8
g/l.
[0030] The surfactant dissolved in the aqueous phase of the suspension of the invention
can be any pharmaceutically acceptable surfactant. Suitable surfactants are nonionic
or cationic surfactants. Preferred are nonionic surfactants like polysorbates and
block copolymers of polyoxyethylene and polyoxypropylene, known as "Poloxamers". Polysorbates
are described in the CTFA International Cosmetic Ingredient Dictionary as mixtures
of esters of fatty acids of sorbitol and sorbitol anhydride condensed with ethylene
oxide, commercially known as "Span". Particularly preferred are non ionic surfactant
of the family known as "Tween", more particularly those surfactants known as "Tween"
e "Tween 80", a commercial polyoxyetylensorbitan mono-oleate.
[0031] A surfactant as described above is present in the concentrated suspension of the
invention in an amount up to the limit of solubility in the aqueous phase.
[0032] Isotonic solution or normal saline contains 9 g/l of salt. Inhalatory suspensions
of the invention are isotonic or about isotonic, but can also be hypotonic or slightly
hypertonic, the overall salt concentration ranging from 4 to 10 g/l of salt. Preferred
salt is sodium chloride.
[0033] The concentration of salt in the concentrated suspension according to the invention
must not be as high to cause coagulation of the particles due to lowering or elimination
of the repulsive barrier among suspended particles, known also as "salting out". This
means that, depending on the case, formation of an isotonic solution in the inhalatory
suspension by dilution of the concentrated non inhalatory suspension may require addition
of salt during dilution to avoid salting out of the concentrated suspension.
[0034] The concentrated non-inhalatory suspension of water insoluble pharmaceutical substances
according to the invention may contain other components, such as pH buffers, preservatives
and excipients, as is known the field.
[0035] The concentrated non-inhalatory suspension of water insoluble pharmaceutical substances
according to the invention can be prepared by first dissolving a pharmaceutically
acceptable surfactant in water to form a rather concentrated solution of surfactant.
[0036] Then the micronized particles of the water insoluble pharmaceutical substance are
slowly added to such solution under stirring. This step is carried out in a small
volume of water, to ensure effective coating of the particles by the surfactant. When
a cationic surfactant is used, interaction between particles of pharmaceutical substance
and surfactant is promoted by controlling the pH of the solution. Possible heat generated
during dissolution can promote adsorption of surfactant on the surface of the particles.
A high energy mixer equipped with turbine having a small holes grid (emulsions type)
is used at a speed of 7,000 rpm for about 10 minutes.
[0037] Then a salt is added, preferably NaCl, which reduces the repulsive forces among the
particles and stabilizes the suspension, possibly causing settling of particles which
in any event can be easily re-dispersed by gentle shaking. Such salt also ensures,
or contributes to ensure, that a solution with the desired salt concentration is formed
by dilution of this concentrated suspension.
[0038] Optionally this concentrated non inhalatory suspension of pharmaceutical substances
is subjected to sterilization by
β irradiation ranging from 2 to 10 KGy or by
γ irradiation ranging from 2 to 8 KGy. It has been found that the sterilization carried
out on the concentrated suspension is fully satisfactory, since a dramatic reduction
of the microbial count was achieved. Also, the particle size distribution of the sterilized
suspension did not vary significantly after sterilization and upon 90 days of aging.
It has also been found that no significant degradation of the pharmaceutical substance
was caused by irradiation, as shown by the high purity of substance after irradiation.
[0039] Simple dilution upon stirring or gentle shaking of the concentrated non inhalatory
suspension of the water insoluble pharmaceutical substances according to the invention
brings about the formation of a ready to use, or extemporaneous, inhalatory suspension.
Dilution is carried out with water or an aqueous solution of salt, depending on whether
dilution with water only generates a normal saline or a slightly hypertonic or hypotonic
solution, as described above, or whether a salt make-up is required. Dilution can
be carried out in conventional mixers at a speed of not more than 500 rpm.
[0040] It has been found that the inhalatory suspension so prepared retains substantially
the particle size distribution of the concentrated non inhalatory suspension, even
upon aging, as well as physical stability.
[0041] When a sterilized concentrated non inhalatory suspension is used, a corresponding
inhalatory suspension can be produced by diluting the concentrated suspension in a
sterile room. This allows to carry out sterilization on small volumes of concentrated
suspensions to generate industrial batches of sterile substances, avoiding terminal
sterilization.
[0042] As an alternative, an inhalatory suspension of pharmaceutical substances can be prepared
by dilution of the concentrated non inhalatory suspension directly before use, e.g.
by a patient. To this purpose, there is provided a kit of components comprising a
metered volume of said concentrated suspension and a metered volume of water or aqueous
solution of a salt, kept in separate containers or in separate compartments of the
same container, intended to be put into contact to form an inhalatory suspension having
the desired concentration of the components. Such inhalatory suspension contains one
or more pharmacological unit of the desired substance ensuring appropriate dosage
level.
[0043] Treatment and handling of concentrated suspensions as opposed to diluted, inhalatory
suspensions, brings about other process advantages that are apparent to a skilled
person, including possibility to handle substances in selected and controlled areas
of plants or laboratories and to treat such suspensions under laminar flow hoods.
EXAMPLES
Examples 1- 4
Preparation of concentrated non-inhalatory suspensions of Beclomethasone Dipropionate
(BDP)
[0044] Table 1 shows the composition of the suspension for each example. Ex. 1 is a comparative
example (no salt).
TABLE 1
| Components |
Amount (g/l) |
| Example |
1 (comp.) |
2 |
3 |
4 |
| Beclomethasone Dipropionate |
2.0 |
2.0 |
2.0 |
4.0 |
| SPAN 20 |
1.0 |
1.0 |
1.0 |
2.0 |
| TWEEN 20 |
5.0 |
5.0 |
5.0 |
10.0 |
| Sodium Chloride |
- |
9.0 |
4.2 |
9.0 |
| Distilled Water |
Suff. to 1 1 |
Suff. to 1 1 |
suff. to 1 1 |
suff. to 1 1 |
| Concentration vs inhalatory suspension |
x5 |
x5 |
x5 |
x10 |
[0045] The surfactants TWEEN 20 and SPAN 20 were added to distilled water and mixed for
5 minutes until complete dissolution at a speed of 1600 rpm in a mixer with a turbine
model Silverson L4RT equipped with a standard mixing head, at room temperature.
[0046] Micronized Beclomethasone Dipropionate (BDP) powder was added slowly under stirring
the solution so obtained. The micronized powder had the following particle size distribution:
d(0.1) 0.44 µm, d(0.5) 1.13 µm e d(0.9) 2.42 µm.
[0047] The BDP was then homogenized in the water solution of the two surfactants for 15
minutes at the speed of 7000 rpm by means of a mixer with a turbine model Silverson
L4RT equipped with standard mixing head and operating at room temperature.
[0048] In examples 2, 3 and 4 sodium chloride was added to the concentrated suspensions,
under stirring.
[0049] With the method of preparation described above non-inhalatory suspensions have been
obtained in which the concentration of BDP is 5 or 10 times (as shown in the last
line of Table 1) the concentration of a commercial inhalatory suspension of BDP (0.4
mg/ml).
[0050] The particle size distribution of such concentrated suspensions was then determined
with a Particle Size Analizer Sympatec immediately after preparation (time t = 0)
and upon aging of 7, 14 and 90 days (t=7; t=14; t=90). The span value is calculated
with the formula Span = [d(0.9) - d(0.1)]/d(0.5), given before in this specification.
[0051] The results obtained are shown in Table 2.
Table 2
| Ex |
Particle Size Distribution (PSD) |
| t = 0 |
t = 7 |
t = 14 |
t = 90 |
| d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
| 1 |
1.03 |
2.39 |
5.18 |
1.74 |
1.11 |
2.60 |
5.23 |
1.58 |
1.11 |
2.70 |
5.40 |
1.59 |
1.29 |
4.12 |
10.68 |
2.27 |
| 2 |
1.09 |
2.54 |
5.58 |
1.76 |
1.11 |
2.58 |
5.36 |
1.65 |
1.09 |
2.58 |
5.49 |
1.70 |
1.10 |
2.74 |
5.89 |
1.74 |
| 3 |
1.09 |
2.47 |
5.15 |
1.64 |
1.11 |
2.62 |
5.51 |
1.68 |
1.11 |
2.60 |
5.44 |
1.67 |
1.07 |
2.50 |
5.16 |
1.63 |
| 4 |
1.12 |
2.74 |
6.66 |
2.02 |
1.13 |
2.78 |
6.07 |
1.77 |
1.09 |
2.70 |
5.71 |
1.71 |
1.17 |
2.95 |
6.14 |
1.68 |
[0052] It appears from the data of Table 2 that the PSD of example 2, 3 and 4 do not vary
significantly over the time, although a settling of solid particles occurs, upon aging
of 90 days. The suspension of Comparative Example 1, however, undergoes a significant
increase of the d(0.5) and d(0.9) fractions after 90 days. In example 2, 3 and 4 the
initial PSD is re-established by simple manual shaking of the suspension. This demonstrates
that the micronized pharmaceutical substance is dispersed in the water solution in
a stable way.
Examples 1a - 4a
Preparation of inhalatory BDP suspensions from the concentrated suspensions.
[0053] The concentrated non inhalatory suspensions containing BDP described in examples
1 to 4 were diluted to form inhalatory suspensions 1a - 4a ready to be administered.
[0054] The diluent was distilled water in the case of example 1a, and distilled water containing
sodium chloride in the case of the other examples. The amount of sodium chloride in
the diluent solution was such as to yield a concentration of 0.9% p/v (isotonic) in
example 2a and 4a, and a concentration of 0.42% p/v (hypotonic) in the case of example
3a. The PSD of the diluted inhalatory suspensions was determined immediately after
their preparation (t= 0). The results are shown in Table 3. The PSD shows that the
suspensions are suitable for inhalatory administration.
Table 3
| Example |
PSD @ t= 0 |
| d0.1 |
d0.5 |
d0.9 |
span |
| 1a |
1.08 |
2.46 |
5.09 |
1.61 |
| 2a |
1.07 |
2.48 |
5.21 |
1.66 |
| 3a |
1.08 |
2.51 |
5.44 |
1.73 |
| 4a |
1.11 |
2.71 |
5.99 |
1.80 |
Examples 5 -10
Preparation of concentrated non-inhalatory suspensions of Budesonide
[0055] Table 4 shows the composition of the suspension for each example. Ex. 5 is a comparative
example (no salt).
Table 4
| Components |
Amount (g/l) |
| Example |
5 (comp.) |
6 |
7 |
8 |
9 |
10 |
| Budesonide |
1.25 |
1.25 |
1.25 |
2.5 |
5.0 |
5.0 |
| TWEEN 20 |
1.0 |
1.0 |
1.0 |
1.0 |
1.0 |
0.5 |
| Sodium chloride |
- |
4.2 |
9.0 |
9.0 |
9.0 |
9.0 |
| Distilled Water |
Suff. to 1 1 |
Suff. To 11 |
Suff. to 1 1 |
suff. to 1 1 |
suff. to 1 1 |
suff. to 1 1 |
| Conc. vs inhalatory susp. |
x 5 |
x 5 |
x 5 |
x 5 |
x 20 |
x 20 |
[0056] The surfactant TWEEN 80 was added to distilled water and mixed for 5 minutes until
complete dissolution at a speed of 1600 rpm in a mixer with a turbine model Silverson
L4RT equipped with a standard mixing head, at room temperature.
[0057] Micronized Budesonide powder was added slowly under stirring the solution so obtained.
The micronized powder had the following particle size distribution: d(0.1) 0.50 µm,
d(0.5) 1.39µm; d(0.9) 3.15 µm.
[0058] The budesonide was then homogenized in the water solution of the surfactant for 15
minutes at the speed of 7000 rpm by means of a mixer with turbine model Silverson
L4RT equipped with standard mixing head and operating at room temperature.
[0059] In example 6, 7, 8, 9 and 10 sodium chloride was added to the concentrated suspensions,
under stirring, in the amount shown.
[0060] With the method of preparation described above non-inhalatory suspensions have been
obtained in which the concentration of budesonide is 5 or 20 times (as shown in the
last line of Table 4) the concentration of a commercial inhalatory suspension of budesonide
(0.25 or 0.5 mg/ml).
[0061] The particle size distribution of such concentrated suspensions was then determined
with a Particle Size Analizer Sympatec immediately after preparation (time t = 0)
and upon aging of 7, 14 and 90 days (t=7; t=14; t=90). The span value is calculated
with the formula given before in this specification.
[0062] The results obtained are shown in Table 5.
Table 5
| Ex |
Particle Size Distribution (PSD) |
| t = 0 |
t = 7 |
t = 14 |
t = 90 |
| d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
| 5 |
0.78 |
1.75 |
3.53 |
1.57 |
0.82 |
1.82 |
3.99 |
1.74 |
0.80 |
1.77 |
3.98 |
1.80 |
0.80 |
1.79 |
4.40 |
2.01 |
| 6 |
0.79 |
1.76 |
3.55 |
1.57 |
0.81 |
1.77 |
3.48 |
1.51 |
0.83 |
1.93 |
3.89 |
1.58 |
0.78 |
1.73 |
3.47 |
1.55 |
| 7 |
0.79 |
1.84 |
3.68 |
1.57 |
0.80 |
1.81 |
3.59 |
1.54 |
0.80 |
1.73 |
3.35 |
1.47 |
0.79 |
1.75 |
3.50 |
1.55 |
| 8 |
0.81 |
1.74 |
3.45 |
1.52 |
0.79 |
1.81 |
3.60 |
1.55 |
NA |
NA |
NA |
NA |
0.81 |
1.98 |
4.06 |
1.64 |
| 9 |
0.77 |
1.75 |
3.48 |
1.55 |
0.79 |
1.86 |
3.78 |
1.61 |
0.80 |
1.81 |
3.62 |
1.56 |
0.78 |
1.77 |
3.53 |
1.55 |
| 10 |
0.77 |
1.75 |
3.48 |
1.55 |
0.79 |
1.79 |
3.56 |
1.55 |
0.80 |
1.77 |
3.48 |
1.51 |
0.76 |
1.76 |
3.52 |
1.57 |
[0063] It appears from the data of Table 5 that the PSD of example 6, 7, 8, 9 and 10 do
not vary significantly over the time, although a settling of solid particles occurs,
even upon aging of 90 days. The suspension of Comparative Example 5 undergoes an increase
of the d(0.9) fraction after 90 days. In the other examples the initial PSD is re-established
by simple manual shaking of the suspension. This demonstrates that the micronized
pharmaceutical substance is dispersed in the water solution in a stable way.
Examples 5a - 10a
Preparation of inhalatory suspensions of budesonide from the concentrated suspensions.
[0064] The concentrated non inhalatory suspensions containing budesonide described in examples
5 to 10 were diluted to form inhalatory suspensions 5a - 10a ready to be administered,
containing 0.25 or 0.5 mg/ml of budesonide.
[0065] The diluent was distilled water in the case of example 5a, and a water solution of
sodium chloride in the other examples. The amount of sodium chloride in the diluent
solution was such as to yield a concentration of 0.9% p/v (isotonic) or a concentration
of 0.42% p/v (hypotonic), depending on the example. The PSD of the diluted inhalatory
suspensions was determined immediately after their preparation (t= 0). For the suspension
of example 8a, 9a and 10a the PSD was determined also after aging of 90 days. The
results are shown in Table 6. The PSD shows that the suspensions are suitable for
inhalatory administration.
Table 6
| Example |
PSD |
| t = 0 |
t= 90 |
| d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
| 5a |
0.80 |
1.74 |
3.41 |
1.50 |
NA |
NA |
NA |
NA |
| 6a |
0.81 |
1.76 |
3.56 |
1.56 |
NA |
NA |
NA |
NA |
| 7a |
0.81 |
1.75 |
3.54 |
1.56 |
NA |
NA |
NA |
NA |
| 8a |
0.80 |
1.78 |
3.54 |
1.54 |
0.80 |
1.88 |
3.75 |
1.57 |
| 9a |
0.84 |
1.77 |
3.54 |
1.47 |
0.78 |
1.72 |
3.49 |
1.57 |
| 10a |
0.79 |
1.81 |
3.53 |
1.51 |
0.79 |
1.76 |
3.61 |
1.60 |
Example 11 (comparative)
Preparation of a suspension of BDP (0.4 mg/ml) containing NaCl 0.9% according to WO
00/25746
[0066] Purpose of this comparative example is to prepare directly an inhalatory suspension
of beclomethasone dipropionate in aqueous solution of sodium chloride and Tween 20
surfactant with the same concentration of the composition of example 2 of WO 00/25746,
then determine the PSD of the suspension so obtained and compare it with the PSD of
inhalatory suspensions of the inventions, which are prepared from concentrated suspensions
in turn prepared using micronized BDP with the same particle size distribution. This
shows whether the preparation process involving an intermediate production of concentrated
suspensions of the invention improves the quality of the final PSD.
[0067] 450 mg of Tween 20, 90 mg of Span 20 and 3.65 g of NaCl were put in a vessel with
450 ml of distilled water and mixed under magnetic stirring for 20 minutes until complete
dissolution of the two components.
[0068] 180 mg of BDP micronized powder were added to the solution so prepared. PSD of the
powder was: d(0.1) 0.44 µm, d(0.5) 1.13 µm e d(0.9) 2.42 µm, namely the same PSD of
the BDP powder used to prepare the concentrated suspensions of examples 1 - 4.
[0069] The BDP powder was then homogenized in the water solution of the two surfactants
for 20 minutes at the speed of 2600 rpm. The BDP concentration was of 0.4 mg/ml.
[0070] The suspension obtained was analyzed to determine its PSD by means of a Particle
Size Analizer Sympatec.
[0071] The results are shown in Table 7.
Table 7
| Ex. 11 |
Particle Size Distribution |
| t=0 |
T = 21 |
t=90 |
| d 0.1 |
d 0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
| |
1.19 |
5.70 |
14.23 |
2.28 |
1.43 |
7.91 |
20.13 |
2.36 |
1.29 |
4.52 |
12.11 |
2.4 |
[0072] The PSD of the inhalatory suspension prepared with the process above shows a substantial
increase of the size of the particles in each fraction, since the time 0. The increase
of the d
0.5 and of the d
0.9 fraction is dramatic. This shows that inhalatory suspensions prepared directly from
powders without high pressure homogenization do not produce powders with the desired
particle size distribution.
Example 12
Sterilization of a x 5 concentrated non inhalatory suspension of budesonide by irradiation
with β or γ rays.
[0073] The concentrated non inhalatory suspension of Example 8 was irradiated with
β rays at a dose of 2,4,6,8 e 10 KGy; and with
γ rays at a dose of 2,4,6,8 KGy.
[0074] The PSD of the suspension was then determined at t = 0, t = 45 and t = 90 days.
[0075] The results are shown in Table 8. A comparison PSD on a non-irradiated sample is
shown at line 1.
Table 8
| Example 12: Particle Size Distribution |
| Dose |
t = 0 |
t = 45 |
t = 90 |
| d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
| Comparison |
0.81 |
1.74 |
3.45 |
1.52 |
0.80 |
1.76 |
3.51 |
1.54 |
0.81 |
1.98 |
4.06 |
1.64 |
| β : 2 KGy |
0.78 |
1.76 |
3.54 |
1.57 |
0.78 |
1.75 |
3.48 |
1.54 |
0.78 |
1.80 |
3.60 |
1.57 |
| β : 4 KGy |
0.79 |
1.87 |
3.82 |
1.62 |
0.78 |
1.81 |
3.65 |
1.58 |
0.78 |
1.77 |
3.52 |
1.55 |
| β : 6 KGy |
0.79 |
1.91 |
3.96 |
1.66 |
0.79 |
1.88 |
3.82 |
1.61 |
0.77 |
1.76 |
3.52 |
1.56 |
| β : 8 KGy |
0.78 |
1.86 |
3.81 |
1.63 |
0.85 |
2.09 |
4.25 |
1.63 |
0.86 |
2.20 |
4.61 |
1.70 |
| β : 10 KGy |
0.78 |
1.89 |
3.96 |
1.68 |
0.77 |
1.72 |
3.46 |
1.56 |
0.76 |
1.70 |
3.44 |
1.57 |
| γ : 2 KGy |
0.78 |
1.82 |
3.66 |
1.58 |
0.79 |
1.76 |
3.51 |
1.54 |
0.78 |
1.70 |
3.39 |
1.53 |
| γ : 4 KGy |
0.79 |
1.88 |
3.86 |
1.63 |
0.79 |
1.74 |
3.49 |
1.55 |
0.78 |
1.77 |
3.53 |
1.55 |
| γ : 6 KGy |
0.79 |
1.84 |
3.75 |
1.61 |
0.79 |
1.76 |
3.53 |
1.56 |
0.77 |
1.82 |
3.67 |
1.59 |
| γ : 8 KGy |
0.78 |
1.83 |
3.82 |
1.66 |
0.78 |
1.86 |
3.80 |
1.62 |
0.77 |
1.71 |
3.45 |
1.57 |
[0076] A test of microbial count was then carried out on the irradiated suspensions to determine
if a satisfactory sterility was achieved. A purity test was also carried out to determine
if any degradation of the pharmaceutical substance budesonide was provoked by the
irradiation treatment.
[0077] As a comparison, a test of microbial count and purity was carrier out also on a sample
of micronized budesonide powder.
[0078] The results are reported in Table 9 and Table 10 below.
Table 9
| BETA IRRADIATION |
| |
Budesonide Powder |
Concentrated Budesonide Suspension (x 5) |
| Intensity of Irradiation (KGy) |
Microbial count UFC/mg |
Purity % |
Microbial count UFC/ml |
Purity % |
| 0 |
13 |
99.15 |
3.5 · 104 |
99.06 |
| 2 |
Sterile |
99.15 |
Sterile |
99.07 |
| 4 |
Sterile |
99.08 |
Sterile |
99.08 |
| 6 |
Sterile |
99.05 |
Sterile |
99.10 |
| 8 |
Sterile |
98.97 |
Sterile |
99.01 |
| 10 |
Sterile |
98.95 |
Sterile |
99.03 |
Table 10
| GAMMA IRRADIATION |
| |
Budesonide Powder |
Concentrated Budesonide Suspension (x 5) |
| Intensity of Irradiation (KGy) |
Microbial count UFC/mg |
Purity % |
Microbial count UFC/ml |
Purity % |
| 0 |
13 |
99.15 |
3.5 · 104 |
99.06 |
| 2 |
Sterile |
98.88 |
Sterile |
98.97 |
| 4 |
Sterile |
98.84 |
Sterile |
98.91 |
| 6 |
Sterile |
98.88 |
Sterile |
98.98 |
| 8 |
Sterile |
98.69 |
Sterile |
98.91 |
Example 12a
[0079] The concentrated non inhalatory suspension sterilized by treatment with
β rays at 10 KGy was then diluted with distilled water to produce a correspondingly
β irradiated inhalatory suspension with a concentration of budesonide of 0.5 mg/ml,
containing also an additional amount of sodium chloride so that the concentration
of sodium chloride in the diluted suspension is 0.9% p/v.
[0080] The concentrated non inhalatory suspension sterilized by treatment with
γ rays at 8 KGy was then diluted with distilled water to produce a correspondingly
γ irradiated inhalatory suspension with a concentration of budesonide of 0.5 mg/ml,
containing also an additional amount of sodium chloride so that the concentration
of sodium chloride in the diluted suspension is 0.9% p/v.
[0081] The PSD at the time 0 is shown in Table 11. The
β or
γ irradiated inhalatory suspensions obtained by dilution of the corresponding
β or
γ irradiated concentrated suspensions have not undergone any significant increase in
the PSD.
Table 11
| PSD |
| Example 12a |
t=0 |
| d0.1 |
d0.5 |
d0.9 |
span |
| Comparison |
0.80 |
1.78 |
3.54 |
1.54 |
| β-10 KGy |
0.78 |
1.80 |
3.70 |
1.62 |
| γ-8 KGy |
0.79 |
1.75 |
3.51 |
1.55 |
Example 13
Sterilization of a x 5 concentrated non inhalatory suspension of beclomethasone dipropionate
by irradiation with β or γ rays.
[0082] The concentrated non inhalatory suspension of Example 2 was irradiated with
β rays at a dose of 2,4,6,8 e 10 KGy; and with
γ rays at a dose of 2,4,6,8 KGy.
[0083] The PSD of the suspension was then determined at t = 0, t = 45 and t = 90 days.
[0084] The results are shown in Table 12. A comparison PSD on a non-irradiated sample is
shown at line 1.
Table 12
| Example 13: Particle Size Distribution |
| Dose |
t = 0 |
t = 45 |
t=90 |
| d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
d0.1 |
d0.5 |
d0.9 |
span |
| Comparison |
1.09 |
2.77 |
6.21 |
1.85 |
1.14 |
2.95 |
6.54 |
1.83 |
1.10 |
2.74 |
5.89 |
1.75 |
| β: 2 KGy |
1.13 |
3.04 |
7.14 |
1.98 |
1.14 |
2.95 |
6.75 |
1.90 |
1.14 |
3.15 |
8.09 |
2.20 |
| β: 4 KGy |
1.15 |
3.19 |
7.82 |
2.10 |
1.12 |
2.91 |
6.57 |
1.87 |
1.07 |
2.73 |
5.98 |
1.80 |
| β: 6 KGy |
1.13 |
3.03 |
7.03 |
1.95 |
1.12 |
2.88 |
6.48 |
1.86 |
1.08 |
2.73 |
5.97 |
1.76 |
| β: 8 KGy |
1.13 |
3.10 |
7.29 |
1.99 |
1.12 |
2.88 |
6.44 |
1.85 |
1.06 |
2.75 |
6.11 |
1.87 |
| β: 10 KGy |
1.12 |
3.00 |
6.98 |
1.95 |
1.12 |
2.90 |
6.52 |
1.86 |
1.08 |
2.76 |
6.11 |
1.82 |
| γ: 2 KGy |
1.14 |
3.06 |
7.07 |
1.94 |
1.12 |
2.89 |
6.49 |
1.86 |
1.07 |
2.76 |
6.26 |
1.88 |
| γ: 4 KGy |
1.15 |
3.06 |
7.09 |
1.94 |
1.14 |
2.94 |
6.68 |
1.88 |
1.07 |
2.75 |
6.16 |
1.85 |
| γ: 6 KGy |
1.14 |
3.04 |
7.07 |
1.95 |
1.12 |
2.93 |
6.74 |
1.91 |
1.08 |
2.76 |
6.16 |
1.84 |
| γ: 8 KGy |
1.13 |
2.98 |
6.98 |
1.96 |
1.11 |
2.89 |
6.65 |
1.91 |
1.09 |
2.76 |
6.11 |
1.82 |
[0085] A test of microbial count was then carried out on the irradiated suspensions to determine
if a satisfactory sterility was achieved. A purity test was also carried out to determine
if any degradation of the pharmaceutical substance BDP was provoked by the irradiation
treatment.
[0086] As a comparison, a test of microbial count and purity was carrier out also on a sample
of micronized BDP powder.
[0087] The results are reported in Table 13 and Table 14 below.
Table 13
| BETA IRRADIATION |
| |
BDP Powder |
Concentrated BDP Suspension (x 5) |
| Intensity of irradiation (KGy) |
Microbial count UFC/ mg |
Purity % |
Microbial count UFC/ml |
Purity % |
| 0 |
7 |
99.73 |
2.1 · 103 |
99.70 |
| 2 |
Sterile |
99.73 |
Sterile |
99.74 |
| 4 |
Sterile |
99.66 |
Sterile |
99.64 |
| 6 |
Sterile |
99.67 |
Sterile |
99.67 |
| 8 |
Sterile |
99.51 |
Sterile |
99.56 |
| 10 |
Sterile |
99.49 |
Sterile |
99.60 |
Table 14
| GAMMA IRRADIATION |
| |
BDP Powder |
Concentrated BDP Suspension (x 5) |
| Intensity of irradiation (KGy) |
Microbial count UFC/ mg |
Purity % |
Microbial count UFC/ml |
Purity % |
| 0 |
7 |
99.73 |
2.1 · 103 |
99.70 |
| 2 |
Sterile |
99.73 |
Sterile |
99.80 |
| 4 |
Sterile |
99.68 |
Sterile |
99.75 |
| 6 |
Sterile |
99.70 |
Sterile |
99.74 |
| 8 |
Sterile |
99.07 |
Sterile |
99.62 |
Example 13a
[0088] The concentrated non inhalatory suspension sterilized by treatment with
β rays at 10 KGy was then diluted with distilled water to produce a correspondingly
β irradiated inhalatory suspension with a concentration of BDP of 0.4 mg/ml, containing
also an additional amount of sodium chloride so that the concentration of sodium chloride
in the diluted suspension is 0.9% p/v.
[0089] The concentrated non inhalatory suspension sterilized by treatment with
γ rays at 8 KGy was then diluted with distilled water to produce a correspondingly
γ irradiated inhalatory suspension with a concentration of BDP of 0.4 mg/ml, containing
also an additional amount of sodium chloride so that the concentration of sodium chloride
in the diluted suspension is 0.9% p/v.
[0090] The PSD at the time 0 is shown in Table 15. The
β or
γ irradiated inhalatory suspensions obtained by dilution of the corresponding
β or
γ irradiated concentrated suspensions have not undergone any significant increase in
the PSD.
Table 15
| PSD |
| Example 13a |
t=0 |
| d0.1 |
d0.5 |
d0.9 |
span |
| Comparison |
1.13 |
2.92 |
6.50 |
1.84 |
| β -10 KGy |
1.14 |
3.08 |
7.18 |
1.96 |
| γ -8 KGy |
1.11 |
2.95 |
6.91 |
1.97 |
1. Concentrated suspension of water insoluble pharmaceutical substances,
characterized by comprising:
a) micronized particles of at least one water insoluble pharmaceutical substance with
a particle size distribution in which the d(0.5) fraction is less than 3 µm, the span
value is less than 2, and such features are retained upon aging the suspension for
90 days; said pharmaceutical substance being present at a concentration of from 5
to 50 times the concentration of a suspension of the same substance for inhalatory
administration;
b) an aqueous solution of a pharmaceutically acceptable surfactant as dispersing medium
for said micronized particles of pharmaceutical substance;
c) a salt dissolved in said aqueous solution, at a concentration that: i) does not
cause coagulation of said particles of pharmaceutical substance; and ii) generates
upon dilution an inhalatory suspension in which the concentration of salt in the aqueous
phase is not higher than 10 g/l.
2. Concentrated suspension according to claim 1, wherein the particle size distribution
of said pharmaceutical substance has a d(0.9) fraction of less than 9 µm.
3. Concentrated suspension according to claim 1, wherein the particle size distribution
of said pharmaceutical substance has a d(0.9) fraction of less than 7 µm.
4. Concentrated suspension according to claim 1, wherein said pharmaceutical substance
is a glucocorticoid.
5. Concentrated suspension according to claim 4, wherein said glucocorticoid is selected
from the group consisting of budesonide, beclomethasone, dexamethasone, flumethasone,
flunisolide, fluticasone, triamcinolone acetonide, mometasone, their pharmacologically
acceptable esters, salt and derivatives.
6. Concentrated suspension of water insoluble pharmaceutical substances,
characterized by comprising:
a) micronized particles of at least one water insoluble pharmaceutical substance with
a particle size distribution in which the d(0.5) fraction is less than 3 µm, the d(0.9)
fraction of less than 7 µm, the span value is less than 2, and such features are retained
upon aging the suspension of 90 days; said pharmaceutical substance being present
at a concentration of between 0.5 and 100 g/l;
b) an aqueous solution of a pharmaceutically acceptable surfactant as dispersing medium
for said micronized particles of pharmaceutical substance;
c) a salt dissolved in said aqueous solution, at a concentration that: i) does not
cause coagulation of said particles of pharmaceutical substance; and ii) generates
upon dilution an inhalatory suspension in which the concentration of salt in the aqueous
phase is not higher than 10 g/l.
7. Concentrated suspension according to claim 6, wherein the concentration of said pharmaceutical
substance is comprised between 1 : 20 g/l.
8. Process for the preparation of a concentrated suspension of water insoluble pharmaceutical
substances,
characterized by comprising the following steps:
a) dissolving a pharmaceutically acceptable surfactant in water to form an aqueous
solution of said surfactant;
b) suspending in said aqueous solution micronized particles of said water insoluble
pharmaceutical substance with a particle size distribution in which the d(0.5) fraction
is less than 3 µm and the span value is less than 2, at a concentration of from 2
to 100 times the concentration of said pharmaceutical substance in a suspension for
inhalatory administration;
c) dissolving a salt in said aqueous solution, at a concentration that: i) does not
cause coagulation of said particles of pharmaceutical substance; and ii) generates
upon dilution an inhalatory suspension in which the concentration of salt in the aqueous
phase is not higher than 10 g/l ;
said steps being carried out under stirring and at a pressure not higher than 2 bar.
9. Process for the preparation of a concentrated suspension according to claim 8, wherein
said steps being carried out under stirring and at atmospheric pressure.
10. Process for the preparation of a concentrated suspension according to claim 8, characterized by further comprising a sterilization step by means of β or γ irradiation at a dose of from 2 to 10 KGy.
11. Process for the preparation of a concentrated suspension according to claim 9, wherein
said irradiation is a γ irradiation at a dose of from 2 to 8 KGy.
12. β or
γ irradiated concentrated suspension of water insoluble pharmaceutical substances,
characterized by comprising:
a) micronized particles of at least one water insoluble pharmaceutical substance having:
i) a particle size distribution in which the d(0.5) fraction is less than 4 µm, the
d(0.9) fraction is less than 9 µm, the span value is less than 2.5 upon aging the
suspension of 90 days;
ii) a reduction in total purity of the active material of less than 0.5% from the
initial purity of the untreated material;
said pharmaceutical substance being present at a concentration of 200 g/l or less;
b) an aqueous solution of a pharmaceutically acceptable surfactant as dispersing medium
for said micronized particles of pharmaceutical substance;
c) a salt dissolved in said aqueous solution, at a concentration that: i) does not
cause coagulation of said particles of pharmaceutical substance; and ii) generates
upon dilution an inhalatory suspension in which the concentration of salt in the aqueous
phase is not higher than 10 g/l.
13. Irradiation treated inhalatory suspension of at least one water insoluble pharmaceutical
substances,
characterized by comprising:
a) micronized particles of at least one water insoluble pharmaceutical substance with
a particle size distribution in which the d(0.5) fraction is less than 3 µm, the d(0.9)
fraction is less than 7 µm, the span value is less than 2, said pharmaceutical substance
being present at a concentration of from 0.1 to 2.0 g/l;
b) an aqueous solution of a pharmaceutically acceptable surfactant as dispersing medium
for said micronized particles of pharmaceutical substance and of a salt in which the
concentration of said salt is not higher than 10 g/l.
14. Kit for the extemporaneous preparation of a suspension of water insoluble pharmaceutical
substances intended for inhalatory administration, characterized by comprising a concentrated suspension of said water insoluble pharmaceutical substances
according to any of claims 1-7 or 12, and a separate diluent in proportions such that
upon mixing said diluent with said concentrated suspension, a suspension ready for
inhalatory administration is obtained, in which said water insoluble pharmaceutical
substance is present at a concentration of from 0.1 to 2.0 g/l.